A model for assessment and direct coaching of skill birth attendants in Nepal: A follow-up enhancement program, 2013-2016

18^th International Conference on Nursing & Healthcare

December 05-07, 2016 Dallas, USA

Shovana Rai, Rita Thapa, Indra Rai and Anil B Shrestha

Nick Simons Institute, Nepal

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Presence of skilled birth attendance (SBA) in safe delivery is an important strategy to reduce newborn and maternal mortality. The major services of SBAs include conducting safe delivery and timely complication management. Thus, the Ministry of Health and Population (MoHP) of Nepal launched in-service training (SBA) since 2007 to Maternal and Neonatal Health (MNH) service providers specially working in rural setting. Over 7000 SBAs have been produced across the country. With follow-up rarely done, large information gaps about these SBA graduates; knowledge and skill retention, working environment and their attitudes. To explore these issues and providing on site coaching with the partnership between National Health Training Center (NHTC) and Nick Simons Institute Follow-Up and Enhancement Program (FEP) has been conducted since 2011. FEP tool was developed and amended after piloting. Quantitative assessments of knowledge and skills followed and provided intensive coaching. Enabling environment, confidence and barriers to safe practice were also assessed. 511 SBAs (91% auxiliary nurse midwives and 9% staff nurse) were followed up from 280 health facilities and among them 25% and 75% SBAs were working in hospitals and below district level health facilities respectively. It shows that SBAs are main delivery service provider of rural setting. They have good competence in overall knowledge and management of postpartum hemorrhage whereas less competence in complication management. Enabling environment in most of the health facilities was inadequate for providing maternal and newborn health services. This survey recommends that training doesn�t necessarily stick unless there is a follow-up and on-site coaching. This program facilitate as an eye-opening at all levels. As a result, MoHP of Nepal has replicated and integrated into GoN system since 2014.

Biography :

Shovana Rai has completed her Master’s degree in Woman’s Health and Development from Institute of Medicine in 2004. Midwifery is the major subject of her Master’s degree. She has completed her Post-graduate Diploma in Health Service and Hospital Management from South Bank University, London in 1993. She has involved as a Researcher in Nepal Maternal Mortality and Morbidity study 2008/09 funded by USAID. She has published three articles related with Reproductive Health in local journals. Currently, she is working with Nick Simons Institute as Follow-up and Enhancement (FEP) Coordinator.

Email: shovana@nsi.edu.np